A gender specialist offers tips on how to deal with this complex issue

Brigit Katz

04.28.15

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On April 25, ABC aired Diane Sawyer’s 20/20interview with former Olympian/Kardashian step dad Bruce Jenner, who made his first public declaration that he identifies as a woman. The episode drew in 16.9 million viewers—about four times the average 20/20 audience—and prompted an outpouring of support for Jenner on social media.

Among the segment’s many revelations was Jenner’s description of his childhood realization that something did not quite jibe with his male body. When he was eight or nine years old, Jenner told Sawyer, he was overcome by an acute and inexplicable desire to wear women’s clothing. Sometimes, when Jenner was home alone, he would venture outside in his mother’s or sister’s dress, his short hair covered by a handkerchief.

Jenner has waited 65 years to reveal what he says is his true self. Thanks to increased awareness and acceptance of gender difference, many trans youths around the country no longer feel compelled to live a life of secrecy and silence. But the process of transitioning can be a difficult one for young trans people and their parents. To gain insight into the unique challenges that these families face, Women in the World spoke to Rachel Pepper, a marriage and family therapist and gender specialist who co-authored a book titled Transgender Child: A Handbook for Families and Professionals.

Women in the World:At what age, on average, do transgender children start to experience a sense of unease in their bodies?

Rachel Pepper: Many transgender adults recall … that they felt gender differences as far back as they can remember. Practitioners in this field report growing evidence that children are often aware of these feelings of difference as early as one year old, and that these children often try to report this difference to family members at around 18 months old, when they are just beginning to really speak. I have heard from many parents that when their child was between 18 months and two years old, their child said things like “Mama, I be a boy” or “I no boy, I girl.” Often parents laugh or think their child is just confused, but what they are actually hearing is a child’s innate and strongly felt expression of gender difference.

Another fairly typical time young people experience distress is when they begin to go through the early stages of puberty, and they realize that changes are happening to their body, further invalidating their core sense of gender identity. Children who are accepted and supported by their parents, and who are allowed to socially and/or medically transition will suffer much less distress than those who are shamed and rejected by their families of origin. Studies show this, over and over again.

WITW: A young boy might like to wear dresses, and a young girl might call herself a boy, but that doesn’t necessarily mean he or she is transgender. At what point is it safe to assume that your child is struggling with gender identity?

RP: There is a difference between gender expression and gender identity. It is also normal for children to engage in imaginative and/or cross-gender play … It is thought by experts that children who are persistent, consistent, and insistent in their gender expression and stated identity, over a period of some time may have a difference that goes beyond mere imagination or experimentation. In other words, something can only be considered a phase if it eventually ends.

WITW: If parents suspect that their child is experiencing body dysphoria what should they do: broach the subject, or wait for their child to come to them?

RP: I think parents can leave the door open for specific conversations on any serious topic by spending time with their children, ensuring their child knows that they will always be loved and supported, and by expressing curiosity and acceptance of differences among all people, whether this be around issues of gender identity, sexual orientation, race, class, culture or ethnicity. If a child has not self-reported yet, and a parent notices possible signs of a child’s possible transgender identity, I’d advise becoming educated about the topic … reaching out to other parents, finding a knowledgeable professional in your area, and of course, talking to your children.

Rachel Pepper/Debra St. John Photography

WITW: Going through a gender transition is obviously difficult for the person experiencing it. But what are some of the main challenges that the parents of transgender children face?

RP: Parents often experience a real sense of grief and loss for the child they believe they had, but who has now gone away. Even looking at old photos of their child can be difficult. It may be helpful for parents to understand that the essence of their child will always be there, but they are now presenting in a different form … Attending supportive play groups, such as the Unicorn Project— a monthly art and activities group my spouse and I started here in the Bay Area—will be helpful in forming community. Parents also need to work to find support for themselves, either in-person or online.

Parents face the challenge of advocating for their children constantly: ensuring their safety at schools, camp and other recreational activities, bringing legal action where necessary to ensure equality, and educating everyone around them in the process. I am continually amazed by the strength and conviction of these mostly heterosexual parents across the country—many of whom had never met a single transgender person before their child came out to them—who are now leaders in the national movement for transgender rights.

WITW: What are some challenges that are unique to transgender children—or in other words, that transgender adults do not face?

RP: I think the biggest challenge facing all transgender people is to be loved and accepted by their families and significant others. A primary difference, of course, is that adults can make their own decision to transition, and children cannot. A child is vulnerable to the prejudices of their parents and caretakers, and thus cannot always live authentically until they convince others of the need, leave their families of origin, or legally come of age.

The good news is that it may be a lot easier for a child to transition than an adult. Children do not have a longer standing public gender identity that they must work to erase or psychologically integrate. They do not have to undergo years of self-doubt and depression, such as recently reported by Bruce Jenner. At younger ages, children transition much more easily socially, often simply growing up as their affirmed gender. And by taking hormone blockers and or cross-hormones as a teenager, trans youth can avoid having to pass through puberty twice. Children who are allowed to live authentically as their affirmed gender are happy, well adjusted kids, usually avoiding any of the emotional trauma that some uninformed people believe they suffer as a result of transitioning.

WITW: In his 20/20 interview, Bruce Jenner said that he has been waiting his whole life for this moment of transparency. Do you think we are moving toward a society in which young trans people can feel comfortable being open about their true selves?

RP: I think we are witnessing a great revolution, where in the span of just one or two generations, our societal thinking about transgender people has radically changed. When my co-author Stephanie Brill and I wrote The Transgender Child, we knew that there were many families out there in need of advice and encouragement. What I didn’t realize at the time was how [widely] this book would travel, and how much families would work to support their children as a result. A child coming out as transgender today may have a chance to live an entire life free from familial or societal discrimination. This is amazing! … As more people come out as trans, and as new generations of youth eradicate the prejudices of the generations before them, I think we will see acceptance and understanding for all transgender and gender independent people within our lifetime.

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